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      Cerebrovascular Alterations in Alzheimer Disease : Incidental or Pathogenic?

      1 , 2

      Circulation Research

      Ovid Technologies (Wolters Kluwer Health)

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          Abstract

          <p class="first" id="P1">Alzheimer’s disease, the leading cause of cognitive impairment in the elderly, has traditionally been considered a disease of neurons. Structural and function alterations of cerebral blood vessels also occur, but direct evidence of a causal involvement in the pathobiology of the disease has been lacking. This Viewpoint will review new data that may help shed light into the intriguing association between vascular and neurodegenerative pathology. </p>

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          Most cited references 7

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          Association Between Midlife Vascular Risk Factors and Estimated Brain Amyloid Deposition.

          Midlife vascular risk factors have been associated with late-life dementia. Whether these risk factors directly contribute to brain amyloid deposition is less well understood.
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            Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial

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              Alzheimer disease and risk of stroke: a population-based cohort study.

              To investigate the risk of stroke in patients clinically diagnosed with Alzheimer disease (AD) compared with non-AD patients with similar vascular risk factors. Using data obtained from Taiwan's National Health Insurance Research Database, we evaluated the risk of ischemic stroke (IS) and intracerebral hemorrhage (ICH) in patients with AD (n = 980) who had no history of stroke, vascular dementia, or other cerebral degenerative diseases. Our evaluation period spanned from 2000 to 2010. We performed a 1:5 case-control matched analysis, in which cases were matched to controls according to their estimated propensity scores, which were based on demographics and existing vascular risk factors. This approach reduced selection bias. Cox proportional hazards regression analysis was then used to estimate the risk of IS and ICH in AD, conditional for matched pairs. Overall, patients with AD had a higher risk of IS and ICH than those without AD. The incidence of IS in AD cases and non-AD controls was 37.8 and 23.2 per 1,000 person-years, with an adjusted hazard ratio of 1.66 (95% confidence interval, 1.37-2.01, p < 0.001). The incidence of ICH in AD cases and non-AD controls was 5.2 and 3.0 per 1,000 person-years, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.03-2.79, p = 0.037). Clinical diagnosis of AD is associated with considerably increased risk of stroke development.
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                Author and article information

                Journal
                Circulation Research
                Circ Res
                Ovid Technologies (Wolters Kluwer Health)
                0009-7330
                1524-4571
                August 03 2018
                August 03 2018
                : 123
                : 4
                : 406-408
                Affiliations
                [1 ]From the Weill Cornell Medicine, Feil Family Brain and Mind Research Institute, New York (C.I.)
                [2 ]Department of Neurology and Epidemiology, Johns Hopkins University, Baltimore, MD (R.F.G.).
                Article
                10.1161/CIRCRESAHA.118.313400
                6214471
                30355253
                © 2018

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